Fisher Deborah, Jeffreys Amy, Bosworth Hayden, Wang Jennifer, Lipscomb Joseph, Provenzale Dawn
Durham Veterans Affairs Medical Center, Institute for Clinical and Epidemiological Research, North Carolina, USA.
Am J Gastroenterol. 2002 Sep;97(9):2193-200. doi: 10.1111/j.1572-0241.2002.05972.x.
Practice guidelines recommend surveillance for Barrett's esophagus (BE) because of the risk of esophageal cancer. The quality of life of patients undergoing surveillance is unknown. The objectives of this study were to develop a new utility instrument to measure quality of life of patients undergoing BE surveillance and determine if Quality of Life in Reflux and Dyspepsia (QOLRD) scores correlate with utility ratings.
Fifteen patients were administered 16 scenarios describing possible BE surveillance outcomes. Each scenario was rated from 0 (equivalent to being dead) to 10 (equivalent to being in perfect health). Each patient also completed the QOLRD, a validated instrument. A t test was performed to compare the QOLRD means with published means. The Spearman's rank correlation coefficient was calculated for the median QOLRD score and the median utility rating.
QOLRD means ranged from 5.80 to 6.65 (previously published means 4.3-5.4). Lower scores denoted a worsened quality of life. The difference was significant (p < 0.001). The correlation coefficient of median QOLRD score (6.8) and median utility rating (4.0) was 0.10 (p = 0.71).
This population of BE patients had significantly higher QOLRD scores than a previously published population referred for endoscopy. Quality of life using the utility measure was reduced. The utility measure did not correlate with the disease-specific instrument, suggesting that the concerns of patients undergoing surveillance are distinct from their reflux symptoms.
由于存在食管癌风险，实践指南建议对巴雷特食管（BE）进行监测。接受监测的患者的生活质量尚不清楚。本研究的目的是开发一种新的效用工具来测量接受BE监测的患者的生活质量，并确定反流和消化不良生活质量（QOLRD）评分与效用评级是否相关。
对15名患者进行了16种描述可能的BE监测结果的情景测试。每个情景的评分从0（相当于死亡）到10（相当于健康状况极佳）。每位患者还完成了QOLRD，这是一种经过验证的工具。进行t检验以比较QOLRD均值与已发表的均值。计算中位数QOLRD评分与中位数效用评级的Spearman等级相关系数。
QOLRD均值范围为5.80至6.65（先前发表的均值为4.3 - 5.4）。较低的分数表示生活质量恶化。差异具有统计学意义（p < 0.001）。中位数QOLRD评分（6.8）与中位数效用评级（4.0）的相关系数为0.10（p = 0.71）。
这群BE患者的QOLRD评分明显高于先前发表的接受内镜检查的人群。使用效用测量法得出的生活质量有所降低。效用测量法与疾病特异性工具不相关，这表明接受监测的患者所关注的问题与其反流症状不同。
